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PubMed2004

Secular trends in hospital-acquired Clostridium difficile disease in the United States, 1987-2001.

We reviewed Clostridium difficile-associated disease (CDAD) data from the intensive care unit (ICU) and hospital-wide surveillance components of the National Nosocomial Infections Surveillance System hospitals during 1987-2001. ICU CDAD rates increased significantly only in hospitals with >500 beds (P<.01) and correlated with the duration of ICU stay (r=0.82; P<.05). Hospital-wide (non-ICU) rates increased only in hospitals with <250 beds (P<.01) and in general medicine patients versus surgery patients (P<.0001). CDAD predominated in general hospitals versus other facility types, and rates were significantly higher during winter versus nonwinter months (P<.01). Thus, prevention efforts should be targeted to high-risk groups in these settings.

Clostridioides difficile↗
PubMed1998

Nutrient contribution of breakfast, secular trends, and the role of ready-to-eat cereals: a review of data from the Bogalusa Heart Study.

Breakfast consumption has been identified as an important factor in the nutritional well-being of children. Several studies have indicated that omission of breakfast or consumption of an inadequate breakfast is a factor contributing to poor school performance and to dietary inadequacies that are rarely compensated for in other meals of the day. Differences have also been observed in the nutrient density of the breakfast meal, depending on whether it was consumed at school or at home. Ready-to-eat cereals make a significant contribution to the nutritional quality of diets of children and young adults. The Bogalusa Heart Study, which began 25 y ago, is an epidemiologic investigation of cardiovascular risk factors and environmental determinants in a biracial pediatric population. The purpose of this review is to present data from the Bogalusa Heart Study and other studies supporting the statements above.

Cardiovascular Diseases↗
PubMed2000

Secular trends in growth and changes in eating patterns of Japanese children.

Changes in the daily macronutrient intake of Japanese children have been studied over the past half century to determine the effects of such changes on a child's healthy growth and development. Data from government and other reports show that in 5-y-old boys in the Tokyo metropolitan area, the intake of fat as a percentage of total energy intake was 12.6%, 20.9%, 28.4%, 33.8%, and 33.2% in 1952, 1960, 1970, 1982, and 1994, respectively. The prevalence of obesity in school-aged children is increasing; recently, nearly 10% of the children in this age group were considered obese. About 5% of obese children experience some adverse effects caused by obesity, eg, hypertension and hyperlipidemia. Nationwide surveys on serum cholesterol concentrations conducted in 1960, 1970, 1980, and 1990 showed that the cholesterol concentrations in 10-19-y-old males and females increased year after year. The height of boys and girls rapidly increased during the 15-y period from 1945 to 1960, and after 1970 the adult height in Japan was thought to have reached its maximum. The factors that contribute to the health problems facing today's Japanese children include their sedentary lifestyle, irregular intake of meals (especially skipping breakfast), and the increasing daily ratio of fat to total energy intake. Presently, changing the sedentary lifestyle is the most significant issue to be resolved.

Adolescent↗
PubMed2000

Secular trends in dietary macronutrient intake in Minneapolis-St, Paul, Minnesota, 1980-1992.

Trends in dietary macronutrient intake were evaluated in population-based surveys conducted in adults aged 25-74 years in 1980-1982, 1985-1987, and 1990-1992 in the seven-county Minneapolis-St. Paul metropolitan area. A 24-hour dietary recall (n = 6,499) was completed by a random 50% sample. The authors obtained energy intake for each macronutrient (protein, carbohydrate, fat, saturated fat, monounsaturated fat, polyunsaturated fat, and alcohol). Tine trends for percentage of total energy were analyzed using a generalized linear mixed model. While energy intake remained stable over time, macronutrient composition changed substantially. In 1980-1982, the caloric distribution for men comprised 15.8% protein, 39.4% fat, 40.9% carbohydrate, and 3.9% alcohol; similar findings were observed in women (15.7% protein, 38.9% fat, 43% carbohydrate, and 2.4% alcohol). From 1980 to 1992, total fat intake decreased 4.7% in men and 4.9% in women (p < 0.001). The decline was greatest for monounsaturated fat, although saturated and polyunsaturated fat intake also fell. During this same period, carbohydrate intake increased 5.7% and 5.8% in men and women, respectively (p < 0.001). Alcohol intake decreased in men and women (p < 0.01), while protein intake remained stable. In summary, the Minneapolis-St. Paul metropolitan area diet shifted substantially during the 1980s toward more carbohydrate and lower fat and alcohol intake.

Adult↗
PubMed1982

Incidence and secular trends of congenital limb defects in Finland.

The total incidence rate of three selected congenital limb defects was 12.8 per 10 000 births in Finland from 1964 to 1977; 1235 cases were reported to the Registry of Congenital Malformations. The incidence rate of reduction limb deformities was 5.0 per 10 000 births (481 cases), of polydactyly 5.8 (559) and of syndactyly 3.1 (299), respectively. The total incidence rate and the rates for all the subgroups had a statistically significant increasing trend even after the incidence rates were compared to the reporting rate of all malformations (p less than 0.01). No significant variations in seasonal distributions were found. In 69% of the reduction deformities only one or both upper limbs were affected, 20% of the children had only lower limb defects, and 11% of the cases had defects in both upper and lower limbs. In 28% of the cases additional malformations were reported. For comparison, incidence rates of the selected limb defects from 13 other national surveillance systems are presented.

Female↗
PubMed1991

Secular trends in social class and sex differences in adult height.

Trends in social class and sex differences in adult mean height in Great Britain since the turn of the century were investigated using data from parents and offspring in the 1946 and 1958 British birth cohort studies (n = 50,000). There has been an increase of 1.09 cm per decade in the mean height of men but only 0.36 cm per decade in the mean height of women. On average men from non-manual origins were 1.97 cm taller than men from manual origins and the figure for women was 1.61 cm. Trends in class differences in height for those born between the beginning of the century and 1958 have been small; fluctuations have occurred over the period but were unsynchronized for men and women.

Adult↗
PubMed1995

The sex ratio of mortality and its secular trends.

BACKGROUND: The mortality level from all causes is different between populations and it has decreased for both men and women in most countries in the last decades. However, there is a difference in the male/female sex ratio of mortality between populations and its time trends and the reasons for these differences remain unclear. METHODS: The sex ratio of all-cause mortality and the main causes of death, i.e. total cardiovascular disease and cancer, for 30 populations in 1988 (mean of 1987-1989), and the time trends of the sex ratio for 27 populations are analysed. RESULTS: Large differences in the sex ratio of mortality exist among the studied populations. The sex ratio of all-cause, total cardiovascular and cancer mortality markedly increased in most countries during recent decades. CONCLUSIONS: The sex ratio of all-cause mortality and its time trends correlated significantly and positively with the sex ratio of mortality and its time trends from total cardiovascular disease and cancer. The differences of the sex ratio of mortality and their time trends between populations cannot be explained by genetic factors. They could be attributed to differences in life style. A different exposure and different reaction to the risk factors of cardiovascular diseases and cancer, e.g. saturated fat intake, alcohol intake and smoking habits, between men and women are considered to be the main causes for these differences in the sex ratio of mortality.

Aged↗
PubMed1998

Secular trends in blood pressure levels in Denmark 1964-1991.

BACKGROUND: Hypertension is an essential risk factor for development of cardiovascular diseases. Prospective studies show a reduction in risk of myocardial infarction with reduction of blood pressure. In Denmark there was a decrease in ischaemic heart disease mortality during the period (1968-1992) with around 34% in 30-65 year old men and 30% in women. OBJECTIVE: To assess the changes in casual blood pressure between 1964 and 1991 in seven cross-sectional population studies. SETTING: Centre of Preventive Medicine, University of Copenhagen, DK-2600 Glostrup. POPULATION: 10359 subjects, equal numbers of men and women, age exactly 30, 40, 50 and 60 years drawn as random samples from a background population of 300000 inhabitants and surveyed in 1964-1974 and five cross-sectional studies 1976, 1978, 1982-1984, 1986-1987 and 1991. METHODS: Blood pressure was measured according to WHO criteria by one technician in each survey. Alcohol consumption and physical activity were measured by a self-administered questionnaire. The weight and height were measured by standardized methods. Data on mortality from ischaemic heart disease were obtained from death certificates recorded by the National Board of Health. RESULTS: Blood pressure increased with increasing age in both genders and was significantly higher in men than in women. Median blood pressure in 50 year old men in 1964 was 135/85 mmHg and in 1991 it was 123/79, whereas in women in 1964 it was 140/85, against 119/74 in 1991. The prevalence of hypertensives among 30 and 40 year olds declined throughout the period. The performance of blood pressure measurements, technical variation, examination programme, seasonal variation and inter-observer variation were potential bias sources and influenced blood pressure levels, but cannot be shown to be responsible for the declining trend in blood pressure and hypertension. Women became a little more physical active in leisure time and men less active. Women consumed less alcohol than men, but the amounts slightly increased by the end of the period. Body mass index >25 was seen less frequently in women than in men and this increased in men over the period. Sale of antihypertensive drugs increased in Denmark over the 1964-1991 period. There seems to be good agreement between the changes in blood pressure in the population and the decline in mortality from stroke and coronary heart disease in Denmark, which is influenced by other risk factors as well. CONCLUSION: Blood pressure distributions have shifted towards lower values in 1964-1991. Prevalence of hypertension declined up to 1983. Risk factor changes as well as treatment for hypertension contribute to this.

Adult↗
PubMed1999

Interpreting the decline in tuberculosis: the role of secular trends in effective contact.

BACKGROUND: The dramatic decline in tuberculosis (TB) in developed countries during the past century has been attributed to many factors, including improvements in living and social conditions and, more recently, effective treatment. Each of these changes should have reduced the average number of individuals 'effectively contacted' (i.e. sufficiently to transmit infection) by each infectious TB case. METHOD: Estimates of the average number of individuals effectively contacted by each infectious TB case, for each year since 1900 in England and Wales, are derived as the ratio between published estimates of the annual risk of infection and estimates of the prevalence of infectious cases, as derived using a published model of the epidemiology of TB. RESULTS: The results suggest that each infectious case contacted, on average, about 22 individuals in 1900 sufficiently to transmit Mycobacterium tuberculosis infection, and that this number declined to about 10 by 1950 and to approximately one by 1990. CONCLUSIONS: Although several factors contributed to the decline in TB in developed countries during this century, a major contributor has been the decline in the number of effective contacts by each case over time. Similar declines have doubtless occurred over the past century for many infections in developed countries.

Adolescent↗
PubMed1993

Secular trends in hepatitis A virus infection among Alaska Natives.

To assess the epidemiologic characteristics of the population susceptible to hepatitis A virus (HAV) infection and determine the natural history of infection, a retrospective survey was done using banked serum specimens. A random sample of 4030 Alaska Natives statewide was selected, stratified by year of birth and community of residence. Overall, 1988 serum samples (49.3%) tested positive for antibody to HAV (anti-HAV). Past HAV infection was strongly age-related, increasing from 7% in persons born since 1975 to 85% among persons born before 1945. Prevalence of infection also varied between regions. In small communities, a clear demarcation typically existed between previously infected older persons and younger anti-HAV-negative persons. This indicated that village-wide outbreaks of HAV infection have been the norm and appear to be dependent on the presence of a young susceptible population. Widespread vaccination with hepatitis A vaccine to maintain a high proportion of young anti-HAV-positive persons may be successful in preventing future epidemics.

Alaska↗
PubMed1977

Secular trends of cerebellar gliomas in children.

Temporal changes in the histologic composition of cerebellar gliomas were examined in a population of 132 children operated on between 1927 and 1968 at The Children's Hospital Medical Center of Boston. Linear trends with time were examined for clinical features, histologic features, and tumor types. We found evidence of an increasing occurrence of glioma A and its associated features during the 41-year study period. This tumor type is associated with a good prognosis and is histologically well defined. Glioma B, a tumor type associated with a poor prognosis, was relatively stable with respect to time and, therefore, differed markedly from glioma A. Foci of oligodendroglia, a glioma A feature, clustered by year of surgery within a relatively short time span. This feature had a survival rate and a male sex proportion quite different from those of the other histologic features investigated.

Cerebellar Neoplasms↗
PubMed1998

Secular trends in the United States black/white hypertension prevalence ratio: potential impact of diminishing response rates.

In this integrative review, the authors analyzed 25 studies on hypertension prevalence among black and white adults (1960-1991). The authors made the following inferences: 1) both female (2.59 vs. 1.77) and male (2.20 vs. 1.38) black/white hypertension prevalence ratios have diminished by approximately a third over the past three decades; 2) response rates were significantly lower among the more recent surveys (i.e., 1976 or later, mean 69.2 percent (standard deviation (SD) 6.9) vs. 1960 to 1975, mean 86.1 percent (SD 9.1)); and 3) these two trends are directly associated--response rates may account for a third (women, R2 = 0.362) to nearly a half (men, R2 = 0.469) of the variability in black-white hypertension differentials. These findings suggest that although respondent-based research has found black and white adults in the United States to be increasingly similar in hypertension prevalence, the same may not be true of the entire adult population (responders and nonresponders). The apparent diminishment over time in the black-white hypertension gap is as likely to be a methodological artifact allied with declining response rates as a true parametric phenomenon resultant from substantive factors such as enhanced treatment effectiveness among blacks.

Adolescent↗
PubMed1985

Secular trends in underreporting of cigarette consumption.

Information on the cigarette smoking habits of all New Zealanders aged 15 years and over was collected in two consecutive national censuses in 1976 and 1981. These data show that the self-reported per capita consumption of cigarettes declined by 9.4 per cent during this five-year period. A comparison of census data with national cigarette sales data for the corresponding years indicated considerable underreporting of cigarette use in the two censuses. However, there was little change in the degree of underreporting between 1976 (28 per cent) and 1981 (30 per cent) and the estimated decline in per capita consumption of cigarettes based on sales data (8.6 per cent) was similar to the census-based estimate. These findings suggest that trends in self-reported consumption are a reliable indicator of national trends in cigarette smoking habits.

Adolescent↗
PubMed1986

The distribution of type I (insulin-dependent) diabetes mellitus by age, sex, secular trend, seasonality, time clusters, and space-time clusters: evidence from Montreal, 1971-1983.

The etiology of insulin-dependent diabetes mellitus remains obscure. In an attempt to clarify some aspects of the epidemiology, including its compatibility with an acute infectious process, the authors undertook in-depth analyses of childhood cases accumulated in a population-based register in Montreal during the period from 1971-1983. Incidence rates increased with age until puberty, at which point they plateaued and decreased. There was no overall difference in incidence between males and females; however, the rate for females peaked approximately two years before the rate for males. While there was some variation over time, there was no evidence of a long-term trend, nor was the yearly variation impressive in magnitude. The findings further indicate that the disease is not characterized by explosive outbreaks. There was slight seasonality, with a 28% higher rate of onset in fall and winter than in spring and summer. There was some evidence of space-time clustering in 1971-1973, but not thereafter. Taken as a whole, these findings do not support the hypothesis that a significant portion of insulin-dependent diabetes is caused by an acute infectious process.

Adolescent↗